How do LAs commission therapies named in EHCPs?

The mechanism, in one line

LAs commission EHCP therapies via joint commissioning with the NHS/ICB, buying therapist time through a service-level agreement. But where therapy sits in Section F, the LA must secure it even if the NHS withdraws. Even where NHS-employed therapists deliver the speech and language, occupational therapy or physiotherapy and the NHS pays their wages, the council is buying their time from the health body at rates set by the contract or service agreement between them.

First: confirm where the therapy sits

Before you commission anything, check which section of the plan the therapy is in. Therapy that educates or trains the child is treated as special educational provision and belongs in Section F, which the council must secure (s.21(5) and s.42(2), Children and Families Act 2014). Therapy recorded as health care provision sits in Section G, which the responsible commissioning body, the Integrated Care Board (ICB), must arrange (s.42(3)). That placement decides which body carries the enforceable commissioning duty, so get it right before you build the contract.

Then: commission delivery

1. For Section F therapy, commission delivery through your joint commissioning arrangement with the ICB or NHS trust, naming the provider, the hours and the start date.
2. Set the route to delivery against the plan: a block contract or a service-level agreement (SLA) with the NHS provider for the bulk of therapy, with the rates and review points written in.
3. Where the NHS provider cannot or will not deliver the specified hours, arrange it another way, for example spot-purchasing time from an independent therapist, so that the Section F provision is actually in place.

If the NHS withdraws: the duty does not transfer

Commissioning the NHS to deliver Section F therapy is how you usually discharge the duty, but it does not move the duty off the council. The s.42(2) obligation is absolute and non-delegable. If the ICB or trust lacks capacity, hands the provision back, or declines the specified hours, the council cannot lawfully leave Section F unmet on the grounds that health has withdrawn. You remain the body a parent enforces against, and you must secure the therapy by another route. For the full legal standard, see the LA’s duty to secure Section F provision.

The Schools White Paper of February 2026 proposes Individual Support Plans and narrowing EHC plans toward the most complex needs over the longer term, with a consultation now live. No changes take effect before September 2030 and current plan holders are protected. The Section F commissioning mechanism set out here is the law today and for the foreseeable term.

This page is general information, not clinical or legal advice.